TOPIC:

My three-year-old son is one month out from diagnosis with some continuing bruising around his knees and occasionally in other spots. He also gets minor petechiae that seem to go away quickly. His nasal discharge is clear and we are not too worried about the current level of bruising, so we are only watching him for now. While we're hopeful that he will go into remission, I am getting emotionally and practically ready for him to start outdoor preschool in September, where they will no doubt run around and bump into trees, possibly trip on rocks, etc. He may not get the green light from the pediatrician and hematologist to go, but then again he might, and the preschool is ready to work with us to keep a watchful eye over him and prevent him from climbing trees, etc.

So far, i have ordered some temporary bracelets from Amazon that seem both fun and easy to write "ITP - low platelets - no NSAIDs" on. I have also ordered some soft knee pads to try out, since he seems to be banging his knees a lot these days.

Other than a written plan and a thorough briefing with regular reminders to the teachers, are there any other things we should be doing to get him ready for preschool? Suggestions for useful supplies or skills or conversations to have would all be much appreciated.

In case anyone finds this helpful, I ordered the following and am happy with all of them:

1) Knee pads:
MINILUJIA Children's Kids Knee Brace Tight Non-Falling Sponge Sleeves Breathable Flexible Elastic Support Protector Cover 2PCS/Pair (XS, Grey)
www.amazon.com/gp/product/B0722VXC1J/ref=oh_aui_detailpage_o01_s00?ie=UTF8&psc=1

2) Soft underwear (without exposed elastic bands that gave him petechiae):
City Threads Boys' Brief Underwear All Cotton for Sensitive Skins SPD Sensory Friendly 3-Pack, Fun Boy -4
Sold by: Jolity
www.amazon.com/gp/product/B008XAPUW2/ref=oh_aui_detailpage_o02_s00?ie=UTF8&psc=1

3) Customizable bracelets (couldn't find any silicone ones, which would have been better/softer):
ID Safety Wristbands Infobands Bracelets for Kids Child Travel Event Field Trip, Outdoor Activity, Waterproof Reusable Adjustable(Set of 6 Boy)
Sold by: Ninja Sports
www.amazon.com/gp/product/B07FCYF2TX/ref=oh_aui_detailpage_o03_s00?ie=UTF8&psc=1

Is "ITP-low platelets-NO NSAIDs" the best thing to write on the bracelet? Or would you suggest other wording?

I'm glad you've found some products that you like. Are you noticing fewer bruises with the knee pads? Does he wear them all the time?

I know you said that he is starting preschool soon, and as a parent I would want to be really sure that there is some benefit to the knee pads before sending him wearing something different like that every day. Kids will be kids, and I would hate for him to be extremely self conscious about his condition or to be subject to teasing because of the knee pads. Even at my lowest platelet counts as a child, I never had any outward "gear" to feel self conscious about. Is this preschool that intense with regard to the risk of falling? You know your child best of course, and he may be pushing for these measures because he doesn't like any bruising, but just my thoughts after going through a childhood with ITP.

Keep us updated about his counts whenever you guys go for more blood work. It sounds like he's doing great so far

Thanks, momto3boys We are waiting to hear back from the clinic about an appointment. It's a bit weird, they seem in no rush to return our calls about making an appointment. I was trying to follow protocol but I may have to call their sick line tomorrow to ask why no one is responding to our messages on the appointment line...

But I digress... you make a great point about the knee pads. They are for now (he likes to crawl around his train tracks at home....) as much as they are for preeschool. The kids are 3-4 years old, and the teachers are very supportive, so i'm not anticipating any bullying. Also, shorts season is only through September, and he could presumably then wear pants with reinforced knees or kneepads under his pants if necessary. I do think it's a higher risk than at other preschools, since they spend 3+ hours a day outside, climbing stuff and the like. It may end up not being the right program for an ITP kid...

An update on my kid's preschool situation: the hematologist has recommended we don't send him until his counts have proven stable above 30,000. He is going strong symptom-wise at the moment (only minor petechiae that come and go), but it's only been two weeks since the last IVIG, so who knows... Preschool starts next Monday. It's an outdoors program but only three hours a day so we are hopeful they will agree to watch him closely and not let him climb (if he stabilizes and gets to go, that is).

Any tips of other kids with ITP in preschool are always welcome...

My son was diagnosed 2 days before his 2nd grade started. He was 15k. We sent him to school anyway, but talked to the principle, homeroom teacher, PE teacher, every after school teacher. We also had a letter from doctor to instruct teachers what to do (basically call me immediately. ). He was mostly OK.
Over the past 2 years, he has one nose bleeding at school (I gave the office all my "magic tools" so when I arrived school in 10 minutes, it was already stopped).
Another incident at playground he just tripped over and bumped his mouth on the ground. When I saw him in office, I could not even see his teeth, there was blood in his mouth and cut on his lip. We went to ER, and he was OK, they did an abdominal ultrasound to check internal bleeding. They also wanted to do a head CT but I chose not to do it because there was not even a bump and he did not complain about headache.
He also bumped his head on hard floor at home once because he stepped on a ball. There was an egg size bump and I could see purple and red on the bump. He was also ok, we just watch any sign of headache and there was none.
All these happened when his number was around 15K.
From your son's symptoms, I would be ok for him to go to school. Of course preschool might be a little different from elementary school. I just told my son's teacher no contact sports, and call me any time if they are not sure, so they call me even if there is a paper cut.

TJ, that is so reassuring to hear that they are cooperative and call you even for paper cuts. Thanks for sharing the stories. I would be petrified but it's good to know that school with low platelets is possible.